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Exploring the impacts of water contaminated by emerging pollutants on pregnant mothers and children

Supervisors: Professor Monica Lakhanpaul, Dr Priti Parikh and Dr Luiza Campos

Exploring the impacts of water contaminated by emerging pollutants on pregnant mothers and children under 5

Background:

Water pollution is responsible for an estimated 1.8 million deaths per year [1]. There is evidence that chemical substances even in very low quantities may cause chronic toxicity, endocrine disruption in humans. Several studies found that chemicals such as lead, methylmercury, polychlorinated biphenyls, arsenic, toluene, manganese, fluoride, chlorpyrifos, tetrachloroethylene, polybrominated diphenyl ethers etc in drinking water affect brain development from the prenatal period through childhood, with long term consequences that affect motor function, learning, and behaviour [2, 3, 4]. Children are most vulnerable because they drink more water each day than adults on a per kg-body weight basis. A study found that exposure to some water pollutants such as persistent organochlorine pollutants, arsenic, fluoride, and untreated water affected have negative effects on height growth of children [5]. The exposure and impacts on child health in LMICs are expected to be particularly severe, considering that most of the wastewater in LMICs is discharged directly to water sources without adequate treatment. Often, communities with limited access to water and sanitation services are located in high density urban settings such as slums, which tend to be located in proximity to highly polluting industrial estates.

Aims/Objectives:

The aim of this research is to understand the exposure pathways, impact and risks as a result of water chemicals for children under 5 and pregnant mothers in Indian slums. 

Objective 1: To identify the exposure pathways for chemicals in water investigated in the current literature and examine the gaps in the current initiatives related to public health and environmental policies and interventions for children and pregnant mothers in a urban, low-income setting.
Objective 2: To assess knowledge and awareness of impact of chemicals on child health and current interventions in this area through a stakeholder workshop. 
Objective 3: To map exposure pathways within a urban case study in slums in Rajasthan, India and understand the behaviours associated with water consumption and usage practices and hence the perceived impact of contaminants.  
Objective 4: To identify and co-develop potential interventions with stakeholders ,to reduce exposure and impacts. 

This study contributes to the achievement of SDG3 (Health), SDG6 (Water), SDG10 (Reduce Inequalities), SDG11 (Human Settlements) and SDG17 (Partnerships).

Methods:
This study will use a case study approach with Jaipur city identified due to prior research and established networks. For objective 1 a systematic review and field work will be required. Water samples will be collected from rivers/lakes,  wells/handpumps, and taps in the city. Samples will be analysed for selected antibiotics, pharmaceuticals and personal care products, heavy metals and pesticides as well as other basic water quality parameters (e.g. turbidity, pH, E.coli/coliforms) during dry and rainy seasons. Chemicals will be determined by liquid-gas mass spectrometry. All analyses will be done in triplicate. Objectives 2-4 will be employ mixed-methods including transect walks, geo-spatial mapping of exposure pathways,  semi-structured interviews and focus group discussion. 

Timeline:

Months 1-4 Literature Review & Ethics Approval; Months 5-6- Preparation for field work, 1st workshop; Months 7-20 - field work/workshop; Months 21-25- data analyses/paper preparation; Months 26-36-final workshop; writing up thesis.

References:
1.    Landrigan PJ, Fuller R, Fisher S, Suk WA, Sly P, Chiles TC, Bose-O'Reilly S. Pollution and children's health. Sci Total Environ. 2019 Feb 10;650(Pt 2):2389-2394. doi: 10.1016/j.scitotenv.2018.09.375. Epub 2018 Oct 2. PMID: 30292994.
2.    Silbergeld EK. Drinking Water and the Developing Brain. Cerebrum. 2016 Jul 1;2016:cer-09-16. PMID: 28058090; PMCID: PMC5198753.
3.    Wasserman GA, Liu X, Parvez F, Ahsan H, Factor-Litvak P, Kline J, van Geen A, Slavkovich V, Loiacono NJ, Levy D, Cheng Z, Graziano JH. Water arsenic exposure and intellectual function in 6-year-old children in Araihazar, Bangladesh. Environ Health Perspect. 2007 Feb;115(2):285-9. doi: 10.1289/ehp.9501. Epub 2006 Oct 18. PMID: 17384779; PMCID: PMC1817715.
4.    Hamadani JD, Tofail F, Nermell B, Gardner R, Shiraji S, Bottai M, Arifeen SE, Huda SN, Vahter M. Critical windows of exposure for arsenic-associated impairment of cognitive function in pre-school girls and boys: a population-based cohort study. Int J Epidemiol. 2011 Dec;40(6):1593-604. doi: 10.1093/ije/dyr176. PMID: 22158669.
5.    Vakil - Asadollahy M, Keikha M, Poursafa P, Kelishadi R. A Systematic Review of the Effects of Environmental Pollutants, Chemical Factors, and Climate Changes on Children’s Height. Health Scope. 2018;7(4):e12864. doi: 10.5812/jhealthscope.12864.